TY - JOUR
T1 - Airway eosinophilia in remission and progression of asthma
T2 - Accumulation with a fast decline of FEV1
AU - Broekema, M.
AU - Volbeda, F.
AU - Timens, W.
AU - Dijkstra, A.
AU - Lee, N. A.
AU - Lee, J. J.
AU - Lodewijk, M. E.
AU - Postma, D. S.
AU - Hylkema, M. N.
AU - Ten Hacken, N. H.T.
N1 - Funding Information:
The authors would like to thank all participants of the study and thank the lung function department of Beatrixoord for their help in the collection of all lung function and sputum data. We thank Dr. B. Barroso for measurement of adenosine in sputum. This study was financially supported by the Dutch Asthma Foundation (Grant AF 3.2.00.38).
PY - 2010/9
Y1 - 2010/9
N2 - Background: As it is unknown whether complete asthma remission or progression of asthma is associated with airway inflammation and remodeling, we assessed these characteristics in bronchial biopsies of relevant subsets of asthma patients. Methods: Sputum and bronchial biopsies were obtained from asthma patients in remission (PC20 histamine > 32 mg/ml, PC 20 AMP > 320 mg/ml) and from those with either a slow FEV 1 decline (<30 ml/year) or fast decline (>30 ml/year). Inflammatory cells and mediators were determined in sputum, inflammatory cells and aspects of airway remodeling in bronchial biopsies. Results: Asthmatics in remission and asthma patients with a slow FEV1 decline had a similar extent of airway inflammation and remodeling in sputum and bronchial biopsies. Asthma patients with a fast FEV1 decline had high sputum eosinophil numbers. Moreover, FEV1 decline (ml/year) correlated with sputum eosinophil numbers (Rs = 0.51, p = 0.003) and ECP levels (Rs = 0.57, p = 0.001). Airway remodeling, i.e. basement membrane thickness, correlated with sputum eosinophils (Rs = 0.69, p < 0.001), sputum ECP (Rs = 0.46, p = 0.018) and airway wall eosinophil numbers (Rs = 0.49, p = 0.002). Conclusions: Asthma, even when in remission, is accompanied by airway inflammation and remodeling. Data suggest that eosinophils are important in a subset of asthma patients by association to accelerated FEV1 decline and change of basement membrane thickness.
AB - Background: As it is unknown whether complete asthma remission or progression of asthma is associated with airway inflammation and remodeling, we assessed these characteristics in bronchial biopsies of relevant subsets of asthma patients. Methods: Sputum and bronchial biopsies were obtained from asthma patients in remission (PC20 histamine > 32 mg/ml, PC 20 AMP > 320 mg/ml) and from those with either a slow FEV 1 decline (<30 ml/year) or fast decline (>30 ml/year). Inflammatory cells and mediators were determined in sputum, inflammatory cells and aspects of airway remodeling in bronchial biopsies. Results: Asthmatics in remission and asthma patients with a slow FEV1 decline had a similar extent of airway inflammation and remodeling in sputum and bronchial biopsies. Asthma patients with a fast FEV1 decline had high sputum eosinophil numbers. Moreover, FEV1 decline (ml/year) correlated with sputum eosinophil numbers (Rs = 0.51, p = 0.003) and ECP levels (Rs = 0.57, p = 0.001). Airway remodeling, i.e. basement membrane thickness, correlated with sputum eosinophils (Rs = 0.69, p < 0.001), sputum ECP (Rs = 0.46, p = 0.018) and airway wall eosinophil numbers (Rs = 0.49, p = 0.002). Conclusions: Asthma, even when in remission, is accompanied by airway inflammation and remodeling. Data suggest that eosinophils are important in a subset of asthma patients by association to accelerated FEV1 decline and change of basement membrane thickness.
KW - Airway inflammation
KW - Airway remodeling
KW - Eosinophils
KW - Lung function decline
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U2 - 10.1016/j.rmed.2010.03.030
DO - 10.1016/j.rmed.2010.03.030
M3 - Article
C2 - 20434897
AN - SCOPUS:77955659342
SN - 0954-6111
VL - 104
SP - 1254
EP - 1262
JO - British Journal of Tuberculosis and Diseases of the Chest
JF - British Journal of Tuberculosis and Diseases of the Chest
IS - 9
ER -